FNAC as a Diagnostic Tool in the Evaluation of Cytomorphological Spectrum of Peripheral Lymphadenopathy along with Histopathological Agreement - An Experience in a Tertiary Teaching Hospital of Northern India

Author(s): Sima Chauhan1 , Simanta Kumar Behera2

BACKGROUND Lymphadenopathy is one of the commonest presentations in clinical practice. Fine Needle Aspiration Cytology (FNAC) is an established, easy, cost effective, diagnostic tool for lymphadenopathies. Judicious application of FNAC can avoid the need of biopsy. We wanted to compare the accuracy of FNAC and histological analysis of peripheral lymphadenopathy among patients visiting the Departments of Oncology, Pathology, Surgery of K.D. Medical College and determine the most prevalent cause of peripheral lymphadenopathy among different age groups of patients. METHODS This study was done among cases of peripheral lymphadenopathy whose FNAC & biopsy were available. 112 cases of lymph node FNACs were carried out in the Dept. of Pathology for a period of one and half years from July 2018 till December 2019. Special stains were used whenever necessary. RESULTS Out of 112 cases studied 68 cases were male and 44 cases were female. Ratio of M : F = 1.5. The commonest anatomical site for lymphadenopathy was cervical (70 %) followed by supraclavicular (13 %) and axillary (10 %). Coming to the spectrum of the disease 103 cases (91.9 %) were non neoplastic lesions and 9 cases 8.03 % were neoplastic lesions. Reactive hyperplastic was the most common condition 51 cases (45.5 %) followed by tuberculosis 34 cases (30.35 %). Out of cases 9 cases (8.03 %) of malignancy, 5 cases (4.4 %) were metastatic deposits & 4 cases (3.57 %) were lymphomas. The peak age group ranged between 21 - 30 years. Cervical location of distribution of lymphadenopathy is noticed to be highest (70 %), which is then followed by, supra clavicular (13 %), axillary (10 %) and inguinal (5 %). (Maximum number of cases were found in the age group of 21 yr. - 30 yr., least number of cases seen in the age group of 61 yr. – 70 yr. Correlative study between cytopathological &and histopathological examination of lymphadenopathy showed diagnostic discordance in three cases and concordance in 109 cases. CONCLUSIONS Apart from reactive hyperplasia, tuberculosis is the commonest cause of lymphadenopathy & males are commonly affected. FNAC is a safe procedure with high degree of sensitivity and specificity and concordance of 96.64 % with histopathological diagnosis. For confirming the diagnosis of lymph nodes, histopathology is the gold standard.